Song Yan, Feng Jun, Dang Ying, Zhao Chao, Zheng Jie, Ruan Litao
Department of Ultrasound, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Vascular Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Ultrasound Med Biol. 2017 Dec;43(12):2947-2953. doi: 10.1016/j.ultrasmedbio.2017.08.1882. Epub 2017 Sep 28.
The aim of this study was to determine the relationship between plaque echo, thickness and neovascularization in different stenosis groups using quantitative and semi-quantitative contrast-enhanced ultrasound (CEUS) in patients with carotid atherosclerosis plaque. A total of 224 plaques were divided into mild stenosis (<50%; 135 plaques, 60.27%), moderate stenosis (50%-69%; 39 plaques, 17.41%) and severe stenosis (70%-99%; 50 plaques, 22.32%) groups. Quantitative and semi-quantitative methods were used to assess plaque neovascularization and determine the relationship between plaque echo, thickness and neovascularization. Correlation analysis revealed no relationship of neovascularization with plaque echo in the groups using either quantitative or semi-quantitative methods. Furthermore, there was no correlation of neovascularization with plaque thickness using the semi-quantitative method. The ratio of areas under the curve (RAUC) was negatively correlated with plaque thickness (r = -0.317, p = 0.001) in the mild stenosis group. With the quartile method, plaque thickness of the mild stenosis group was divided into four groups, with significant differences between the 1.5-2.2 mm and ≥3.5 mm groups (p = 0.002), 2.3-2.8 mm and ≥3.5 mm groups (p <0.001) and 2.9-3.4 mm and ≥3.5 mm groups (p <0.001). Both semi-quantitative and quantitative CEUS methods characterizing neovascularization of plaque are equivalent with respect to assessing relationships between neovascularization, echogenicity and thickness. However, the quantitative method could fail for plaque <3.5 mm because of motion artifacts.
本研究旨在利用定量和半定量对比增强超声（CEUS），确定颈动脉粥样硬化斑块患者不同狭窄组中斑块回声、厚度与新生血管形成之间的关系。总共224个斑块被分为轻度狭窄（<50%；135个斑块，60.27%）、中度狭窄（50%-69%；39个斑块，17.41%）和重度狭窄（70%-99%；50个斑块，22.32%）组。采用定量和半定量方法评估斑块新生血管形成，并确定斑块回声、厚度与新生血管形成之间的关系。相关性分析显示，在使用定量或半定量方法的组中，新生血管形成与斑块回声均无关系。此外，使用半定量方法时，新生血管形成与斑块厚度也无相关性。轻度狭窄组中曲线下面积比（RAUC）与斑块厚度呈负相关（r = -0.317，p = 0.001）。采用四分位数法，将轻度狭窄组的斑块厚度分为四组，1.5-2.2毫米组与≥3.5毫米组之间（p = 0.002）、2.3-2.8毫米组与≥3.5毫米组之间（p <0.001）以及2.9-3.4毫米组与≥3.5毫米组之间（p <0.001）存在显著差异。在评估新生血管形成、回声性和厚度之间的关系方面，表征斑块新生血管形成的半定量和定量CEUS方法是等效的。然而，由于运动伪像，定量方法对于<3.5毫米的斑块可能不适用。
